Primary carcinoma of the broad ligament. Report of four cases and review of the literature.

The clinical and pathologic features of four new and eight previously reported primary carcinomas of the broad ligament have been reviewed. The patients' ages ranged from 29 to 70 years (average, 46) and the most common clinical presentations were vague lower abdominal pain, a palpable pelvic mass, and an associated disorder such as pelvic endometriosis. The tumors ranged from 4.5 to 13 cm in greatest dimension and were solid, cystic, or mixed. All of them were unilateral. Review of the pathologic descriptions and illustrations of the cases in the literature and microscopic review of one reported case revealed that four of the tumors were endometrioid carcinomas, four were clear cell carcinomas, one was probably a mucinous adenocarcinoma, two were papillary adenocarcinomas of undetermined cell type, and one was a serous papillary cystadenoma of borderline malignancy with microinvasion. Three patients were treated by excision of the tumor alone. Seven of them were treated by total abdominal hysterectomy and salpingo-oophorectomy; three patients received postoperative radiation therapy, and one of them also received chemotherapy. Eight patients were free of disease 6 months to 7 years postoperatively, and one patient with distant metastasis (rib) at the time of operation lived for 27 months. In three cases no follow-up data were available. Three of the four patients in current series were found to have pelvic endometriosis at the time of operation. Three of their carcinomas were endometrioid and one was of clear cell type, suggesting the possibility of an origin from endometriotic tissue in the broad ligament.